Guidewire insertion aid

ABSTRACT

[Issue] To provide a guidewire insertion aid which is very easy to operate because a lubricated guidewire can be easily fed out. 
     [Means of Resolution] A guidewire insertion aid  11  according to the present invention is used for feeding out a guidewire  1  inserted in a housing  2  in order to insert said guidewire into the lumen of a piece of medical equipment. The insertion aid  11  comprises: a main body  21 , a housing support part  22  and a guidewire support part  26 . A sliding contact part  28  is disposed between the housing support part  22  and the guidewire support part  26 . The sliding contact part  28  extends in the lengthwise direction of the main body and has a sliding contact surface  28  for the guidewire  1 . A feed-out member  51  is provided on the main body  21  and has a water-retentive water-retention member  52 . The feed-out member  51  is disposed with the water-retention member  52  side thereof facing towards the sliding contact surface  29 . The feed-out member  51  can be displaced while the guidewire  1  is held between said feed-out member and the sliding contact part  28.

TECHNICAL FIELD

The present invention relates to a guidewire insertion aid for insertinga guidewire into the lumen of a piece of medical equipment.

PRIOR ART

When medical procedures are undertaken, it is sometimes conventionallynecessary to insert a guidewire into the lumen of a piece of medicalequipment. A guidewire is normally housed inserted in a tubular housing.A guidewire insertion aid for assisting in the operation to feed out theguidewire is then attached to the housing (see Patent Document 1, forexample). A conventional guidewire insertion aid comprises a main bodyand a housing support part is provided at the base end of the main body.The housing for housing the metal guidewire is detachably supported bythe housing support part. A cylindrical guidewire support part which isopen at the tip end is provided at the tip end of the main body. Theguidewire which has been fed out from the housing is inserted into andsupported by the guidewire support part. A sliding contact part having asliding contact surface is provided in the main body between the housingsupport part and the guidewire support part.

The following procedure is carried out when the guidewire is insertedinto the body using this kind of guidewire insertion aid, for example. Apractitioner first of all grips the main body, pinching it with thefingers of one hand in such a way that the guidewire support part is atthe front. The practitioner then moves his or her thumb forwards inorder to feed the guidewire outwards and forwards so that it projectsfrom the tip end of the guidewire support part.

Furthermore, in addition to the abovementioned type of metal guidewire,there are also those that are known as lubricated guidewires having astructure in which a coating of lubricant is applied to the surface ofthe wire. There are also devices which are known in the art forproviding lubrication by wetting the lubricated guidewire (see PatentDocument 2, for example). These types of devices enable smooth insertionof the lubricated guidewire.

PRIOR ART DOCUMENTS Patent Documents

-   [Patent Document 1] Japanese Unexamined Utility Model Application    Publication H7-22752-   [Patent Document 2] U.S. Pat. No. 5,242,428

DISCLOSURE OF THE INVENTION Issues to be Resolved by the Invention

However, when conventional guidewire insertion aids are used, thepractitioner's fingers end up slipping over the lubricated guidewire andthe sliding contact surface when he or she attempts to push out thelubricated guidewire. This means that it is not possible to feed out thelubricated guidewire in the skilful manner which would be possible witha metal guidewire. It is therefore not possible to use a conventionalunmodified metal guidewire insertion aid, and it is necessary to use aninsertion aid especially for lubricated guidewires. Accordingly, in suchcases, the practitioner needs to carry out an operation by holding thedevice with one hand while feeding out the lubricated guidewire with theother hand, which unfortunately occupies both hands. As a result thereare problems in terms of ease of operation.

The present invention has been devised in view of the issues outlinedabove, and the object thereof lies in providing a guidewire insertionaid which is very easy to operate because the lubricated guidewire canbe easily fed out.

Means of Resolving the Issues

The following means 1 to 6 are given as means for resolving the issuesoutlined above.

[1] A guidewire insertion aid for feeding out a guidewire inserted in ahousing in order to insert said guidewire into the lumen of a piece ofmedical equipment, said guidewire insertion aid being characterized inthat it comprises: a main body having a tip end part and a base endpart; a housing support part which is provided at the base end part inorder to detachably support the housing on the main body; a guidewiresupport part of cylindrical shape and open at the tip end, which isprovided at the tip end part in order to support the guidewire passingtherethrough which has been fed out from the housing; a sliding contactpart which is disposed between the housing support part and theguidewire support part, and extends in the lengthwise direction of themain body and has a guidewire sliding contact surface; and a feed-outmember which is provided on the main body and has a water-retentivewater-retention member, wherein the feed-out member is disposed with thewater-retention member side thereof facing towards the sliding contactsurface, and can be displaced while the guidewire is held between saidfeed-out member and the sliding contact part.

Therefore, according to the invention disclosed in means 1, thewater-retention member side of the feed-out member and the slidingcontact surface side of the sliding contact part are disposed facingtowards each other, and the feed-out member is displaced with a fingerin the lengthwise direction while the guidewire is held between theabove members. When this operation is carried out, the guidewire can befed out at the tip end side of the main body by way of the feed-outmember. The water-retention member of the feed-out member iswater-retentive and therefore able to hold liquid for lubrication. Thismeans that when the feed-out operation is carried out using the feed-outmember, the guidewire can be fed out while retaining lubricatingproperties as a result of contact between the water-retention member andthe guidewire. Furthermore, this configuration makes it possible for thepractitioner to feed out the guidewire using a finger, without directlycontacting the guidewire. As described above, the insertion aid of means1 makes it possible for a lubricated guidewire to be easily fed out, andis therefore very easy to operate.

[2] A guidewire insertion aid according to means 1, characterized inthat feed-out member support parts having a guide part which extends inthe lengthwise direction of the main body are provided on the main bodyabove where the sliding contact part is located; and the feed-out memberis a feed-out block having the water-retention member on the lowersurface thereof, and is supported by the feed-out member support partsin such a way as to be able to move forwards or backwards in thelengthwise direction of the main body.

Therefore, according to the invention disclosed in means 2, thewater-retention member side of the feed-out block and the slidingcontact surface side of the sliding contact part are disposed beforehandfacing towards each other. The feed-out block is then moved forwards orbackwards using a finger while the guidewire is held between the abovemembers. When this operation is carried out, the guidewire can be fedout at the tip end side of the main body by way of the feed-out block.The feed-out block is guided by means of the guide part while beingsupported by the feed-out member support parts, and therefore it ispossible to achieve reliable back-and-forth movement in the lengthwisedirection of the main body.

[3] A guidewire insertion aid according to means 2, characterized inthat an urging member for urging the feed-out block in the direction ofthe base end part of the main body is provided between the feed-outblock and the feed-out member support part.

Therefore, according to the invention disclosed in means 3, the feed-outblock is moved outwardly using a finger in order to feed out theguidewire at the tip end side of the main body, after which, when thefinger is moved away, the feed-out block is automatically moved in theopposite direction by means of the urging force of the urging member soas to return to its original position. Consequently it is unnecessary toreturn the feed-out block, and the ease of operation is furtherimproved.

[4] A guidewire insertion aid according to means 1, characterized inthat the feed-out member is a feed-out block having the water-retentionmember on the lower surface thereof, and is linked to the main body byway of a flexible linking member.

Therefore, according to the invention disclosed in means 4, thewater-retention member side of the feed-out block and the slidingcontact surface side of the sliding contact part are disposed facingtowards each other, and the feed-out block is moved forwards orbackwards using a finger while the guidewire is held between the abovemembers. When this operation is carried out, the guidewire can be fedout at the tip end side of the main body by way of the feed-out block.Even though the flexible linking member links the main body and thefeed-out block, this linking member can deform when the feed-out blockmoves forwards or backwards. Consequently, there is no obstruction tothe back-and-forth movement. Furthermore, this structure involves fewercomponents and is simpler than the case in which the feed-out member isprovided separately.

[5] A guidewire insertion aid according to means 1, characterized inthat feed-out member support parts are provided on the main body abovewhere the sliding contact part is located; and the feed-out member is anendless feed-out belt having a water-retention member on the outerperipheral surface thereof, and is supported by the feed-out membersupport parts in such a way as to be able to move circumferentially.

Therefore, according to the invention disclosed in means 5, thewater-retention member side of the feed-out belt and the sliding contactsurface side of the sliding contact part are disposed beforehand facingtowards each other. The feed-out belt is then moved circumferentiallyusing a finger while the guidewire is held between the above members.When this operation is carried out, the guidewire can be fed out at thetip end side of the main body by way of the feed-out belt.

[6] A guidewire insertion aid according to any one of means 1 to 5,characterized in that a water-retention member is also provided on thesliding contact surface.

Therefore, according to the invention disclosed in means 6,water-retention members come into contact with the guidewire from twodirections. Consequently, the guidewire can be reliably lubricated evenif the sliding contact surface is short.

Advantages of the Invention

Therefore, according to the inventions disclosed in claims 1 to 6, thereis provided a guidewire insertion aid which is very easy to operatebecause the lubricated guidewire can be easily fed out.

BRIEF DESCRIPTION OF THE FIGURES

[FIG. 1] is a front view showing the situation when the guidewireinsertion aid according to a first mode of embodiment of the presentinvention is fitted to the housing;

[FIG. 2] is an enlarged plan view of the main parts showing theguidewire insertion aid according to the first mode of embodiment;

[FIG. 3] is an enlarged front view of the main parts showing theguidewire insertion aid according to the first mode of embodiment;

[FIG. 4] is an enlarged front view of the main parts showing theguidewire insertion aid according to a variant example of the first modeof embodiment;

[FIG. 5] is an enlarged front view of the main parts showing theguidewire insertion aid according to the second mode of embodiment;

[FIG. 6] is an enlarged front view of the main parts showing theguidewire insertion aid according to the second mode of embodiment;

[FIG. 7] is an enlarged front view of the main parts showing theguidewire insertion aid according to the third mode of embodiment;

PREFERRED MODES OF EMBODIMENT OF THE INVENTION First Mode of Embodiment

A guidewire insertion aid 11 according to the first mode of embodimentof the present invention will be described in detail below withreference to FIGS. 1 to 4.

FIG. 1 shows the guidewire insertion aid 11 and housing 2 according tothis mode of embodiment. The housing 2 comprises a synthetic resin tubewound into two or three layers in which a guidewire 1 is housed in aninserted state. A synthetic resin holder 3 has the role of retaining thewound form of the housing 2. To be more specific, the holder 3 accordingto this mode of embodiment comprises a substantially C-shaped base part4 and a pair of latching parts 5 which are provided at the two ends ofthe base part 4. A plurality of latching grooves 6 are formed in each ofthe latching parts 5, and the housing 2 is fitted into and latched bythe latching grooves 6. A lubricated guidewire having a structure inwhich a coating of lubricant is applied to the surface of the wire isused here as the guidewire 1 in this mode of embodiment. Depth marks aremarked on the surface of the wire at prescribed lengths. In this mode ofembodiment, the tip end of the wire is bent into a J-shape. It should benoted that the tip end of the wire may equally be angled or straight,rather than being J-shaped.

As shown in FIGS. 1 to 3, the guidewire insertion aid 11 according tothis mode of embodiment comprises a main body 21 made of synthetic resin(polypropylene, for example). The main body 21 has a globally elongateshape in the front to rear direction. A housing support part 22 isprovided as a single piece at the base end part of the main body 21. Oneend of the housing 2 is detachably engaged with an engaging hole 23which forms an opening in the rear end surface of the housing supportpart 22. The housing 2 is supported in the housing support part 22 bymeans of this engagement.

A guidewire support part 26 is then provided as a single piece at thetip end part of the main body 21. The diameter of the guidewire supportpart 26 decreases towards the tip end, and said guidewire support part26 has a hollow cylindrical shape which is open at the tip end. Theguidewire 1 which has been fed out from the housing 2 side passesthrough the inside of the guidewire support part 26. As a result, theguidewire 1 is supported by the guidewire support part 26.

The main body 21 has, in the centre of the lower surface thereof, a rib27 which extends in the lengthwise direction of the main body. Thepresence of the rib 27 increases the overall rigidity of the main body21. An arm part 31 extending downwards in an arcuate shape is providedas a single piece with the main body 21 and projecting from the lowersurface thereof. A holding part 32 having a substantially “

”-shaped cross section is provided as a single piece at the tip end ofthe arm part 31. The holding part 32 holds the housing 2 by means ofengagement with the outer peripheral surface of the housing 2. As aresult, it is unlikely that positional offset will be produced betweenthe guidewire insertion aid 11 and the housing 2. Furthermore, when thepractitioner grasps the guidewire insertion aid 11 with one hand, he orshe can hook the fingers other than the thumb F1 on the arm part 31.This means that it is simple for the practitioner to grasp the guidewireinsertion aid 11.

As shown in FIGS. 1 to 3, a sliding contact part 28 which extends in thelengthwise direction of the main body is disposed in the main bodybetween the housing support part 22 and the guidewire support part 26.The upper surface of the sliding contact part 28 forms a sliding contactsurface 29 with which the guidewire 1 makes sliding contact along theaxial direction thereof.

As shown in FIG. 3 etc., a projection 24 which projects slightly towardsthe upper side of the main body 21 is provided on the main body 21 closeto where the guidewire support part 26 is positioned, to be morespecific, close to the base end opening of the guidewire support part26. A rubber ring 35 is then attached correspondingly to the position ofthe projection 24. If the rubber ring 35 is disposed further to the rearthan the projection 24 (the right-hand side in FIGS. 2 and 3), therubber ring 35 comes into contact with the guidewire 1, which is therebyfixed. A force to return the guidewire 1 to a linear state from thewound state then acts thereon. However, this force alone prevents theguidewire 1 from being fed out naturally. If, on the other hand, therubber ring 35 is disposed further to the front than the projection 24(the left-hand side in FIGS. 2 and 3), the rubber ring 35 does not comeinto contact with the guidewire 1. As a result, the guidewire 1 isreleased, and the guidewire 1 moves more freely than when it is in theabovementioned state of fixed contact.

As shown in FIGS. 2 and 3, a pair of feed-out member support parts 42are provided projecting opposite each other with a gap therebetween onthe main body 21 above where the sliding contact part 28 is located. Alinear guide part 43 extending in the lengthwise direction of the mainbody is formed at a position on the upper side of each of the pair offeed-out member support parts 42. One of the feed-out member supportparts 42 is formed with a latching protrusion 44 close to the end edgeof the guide part 43. A window part 45 is formed at a position on thelower side of each of the pair of feed-out member support parts 42.

A feed-out block 51 serving as a feed-out member is supported betweenthe pair of feed-out member support parts 42 in such a way as to be ableto move forwards or backwards in the lengthwise direction of the mainbody. A water-retentive water-retention member 52 is provided on thelower surface of the feed-out block 51. It should be noted that asimilar water-retention member 57 is also provided on the slidingcontact surface 59 side of the sliding contact part 58. The twowater-retention members 52, 57 are disposed opposite each other with theguidewire 1 held therebetween. A plurality of anti-slip protrusions 53which are intended to improve the ease of operation are provided on theupper surface of the feed-out block 51. A latching protrusion 55 isprovided on one side surface of the feed-out block 51. The latchingprotrusion 55 is disposed in the guide part 43, and the tip end of thelatching protrusion 55 exits through the guide part 43, projectingoutwards of the feed-out member support parts 42. A coil spring 56serving as the urging member is provided between the latching protrusion55 on the feed-out block 51 side and the latching protrusion 44 on thefeed-out member support part 42 side. The coil spring 56 serves to applya spring force which urges the feed-out block 51 in the direction of thebase end part of the main body 21.

The water-retention members 52, 57 are preferably formed using amaterial which is not only water-retentive (water-absorbent), but alsohas frictional properties (properties such that it does not readilyslide). Specifically, a nylon nonwoven fabric or cotton such as gauze,or similar, is preferred as the material for forming these members. Thatis to say, a fibre assembly such as a fabric is advantageous in that itpresents minute surface-unevenness, and therefore suitable frictionalproperties can be readily achieved. Furthermore, the abovementionedfibre assembly is advantageous in that it comprises inter-fibre pores,and therefore it readily retains moisture. It should be noted that fibreassemblies in which the fibres themselves are water-absorbent areespecially preferred as the material for forming these members.

The method for inserting a catheter employing the abovementionedguidewire insertion aid 11 will be described below.

The patient's skin around the insertion point is sterilized beforehand,after which a local anaesthetic is applied to the insertion point. Asyringe containing heparinized physiological saline or the like isfitted to a cannula for indwelling use in blood vessels and the bloodvessel is punctured. Once return-flow of blood has been confirmed, themetal needle of the cannula for indwelling use in blood vessels is held,and the plastic cannula alone is advanced into the blood vessel where itis made indwelling.

The abovementioned guidewire insertion aid 11 is then used to make theguidewire 1 pass through the indwelling cannula, and the guidewire 1 isinserted into the blood vessel.

In this case, one end of the housing 2 in which the guidewire 1 iscurrently housed is engaged with the engaging hole 23 in the housingsupport part 22, and the inside of the housing 2 is pre-filled withheparinized physiological saline injected from the other end thereof. Ifnecessary, the water-retention members 52, 57 may also be pre-soakedwith physiological saline or heparinized physiological saline. At thispoint, the rubber ring 35 is still disposed further to the rear than theprojection 24, and the guidewire 1 is fixed in such a way that it cannotbe naturally fed out. Moreover, it is confirmed that the tip end of theguidewire 1 is inside the guidewire support part 26.

At this point, the practitioner grips the main body 21 with the fingersof one hand in such a way that the guidewire support part 26 is at thefront. The tip end of the guidewire support part 26 is then introducedinto the plastic cannula, and the rubber ring 35 is positioned furtherto the front than the projection 24 by pushing the rubber ring 35upwards using the thumb F1. The guidewire 1 is then fed out in thisstate. Specifically, as shown in FIG. 3, the pad of the thumb F1 isplaced against the upper surface of the feed-out block 51, and thefeed-out block 51 is slid towards the tip end side of the main body(i.e. moved outwardly) while being depressed. When this takes place, theguidewire 1 is held between the water-retention member 52 on thefeed-out block 51 side and the water-retention member 57 on the contactsurface 59 side. The guidewire 1 is then fed out along with the movementof the feed-out block 51. At this point, the water-retention members 52,57 are in contact with the guidewire 1. Lubrication of the surface ofthe guidewire 1 is therefore maintained without drying of thephysiological saline or heparinized physiological saline. It should benoted that the feed-out block 1 automatically returns to its originalposition under the spring force of the coil spring 56 when the thumb F1is removed from the feed-out block 51 which has been slid to the tip endside of the main body.

As a result of carrying out the abovementioned feed-out operation, theguidewire 1 is inserted into the blood vessel through the cannula. Whenthis operation is carried out, radiography should be used in order toconfirm that the guidewire 1 is present at the intended position.

Once insertion of the guidewire 1 has been completed, the cannula iswithdrawn and a small surgical incision is made at the insertion pointusing a scalpel for skin incisions. At this point, the subcutaneoustissue and the blood vessel insertion opening are adequately dilated bypressing a dilator forward along the guidewire 1. The dilator is removedafter dilation. Next, a catheter whereof the lumen is filled withheparinized physiological saline is slowly inserted along the guidewire1. In this process, the catheter is pressed forwards up to the intendedindwelling position while the depth marks are confirmed. Once it hasbeen confirmed that the catheter is indwelling in the intended position,the guidewire 1 is withdrawn. The air in the lumen of the catheter isthen removed by means of a normal method, and the lumen is flushed withphysiological saline or heparinized physiological saline in order toprevent coagulation of the blood. At this point radiography ispreferably used to confirm that the catheter is not looped inside thebody, and that the tip end of the catheter is in the intended position.After this the catheter is secured using a catheter fixing implement anda threaded suture needle together with dressing, and the series ofoperations for inserting the catheter is complete.

As described above, the following operational advantages aredemonstrated with this mode of embodiment.

(1) With the guidewire insertion aid 11 according to this mode ofembodiment, the water-retention members 52, 57 come into contact withthe guidewire 1 during the feed-out operation employing the feed-outblock 51. As a result, the guidewire 1 can be fed out at the tip endside of the main body. Furthermore, this configuration makes it possiblefor the practitioner to feed out the guidewire 1 without directlycontacting the guidewire with his or her thumb F1. This means that thepractitioner's thumb F1 does not end up sliding over the guidewire 1 andthe sliding contact surface 29, unlike when a conventional guidewireinsertion aid is used. Moreover, there is no concern that contact by thethumb F1 will cause a partial loss of lubrication.

As described above, with this guidewire insertion aid 11, the lubricatedguidewire 1 can be easily fed out using one hand. This means that bothof the practitioner's hands are not occupied during operations, and itis possible to achieve superior ease of operation.

(2) With the guidewire insertion aid 11 according to this mode ofembodiment, the feed-out block 1 automatically returns to its originalposition under the spring force of the coil spring 56 when the thumb F1is removed after the feed-out block 1 feed-out operation. This meansthat there is no need to return the feed-out block 51 using the thumbF1, and the ease of operation is further improved.(3) The guidewire insertion aid 11 according to this mode of embodimentis provided with the rubber ring 35 and the projection 24. Consequentlyit is possible to fix the guidewire 1 in such a way that it cannotescape, as required. This means that it is possible to prevent inadvance a situation such as the guidewire 1 escaping from the tip end ofthe guidewire insertion aid 11 due to vibration during transportation,for example. It is therefore possible to produce a very reliableproduct.(4) The guidewire insertion aid 11 according to this mode of embodimentemploys a structure in which the feed-out block 51 is disposed insertedbetween the pair of feed-out member support parts 42, the linear guidepart 43 is provided on the feed-out member support parts 42, and thelatching protrusion 55 is disposed on the guide part 43. The feed-outblock 51 is therefore guided by means of the guide part 43 while beingsupported by the pair of feed-out member support parts 42. Consequentlyit is possible to achieve reliable and smooth back-and-forth movement inthe lengthwise direction of the main body.

FIG. 4 shows a guidewire insertion aid 11A according to a variantexample of the first mode of embodiment. In this variant example theshape of the guide part 43 is slightly different. That is to say, adownwardly curved part 43 a is formed at the tip end side of the guidepart 43. This means that after the feed-out block 51 has been moved asfar as possible to the tip end side of the main body, it can be latchedwith the latching protrusion 55 received in the curved part 43 a. As aresult, the feed-out block 51 is held in position at the tip end side ofthe main body in such a way that it cannot move. Furthermore, thedistance between the water-retention member 52 on the feed-out block 51side and the water-retention member 57 on the sliding contact surface 59side is reduced. Consequently, the guidewire 1 is reliably pinchedbetween the two so that the guidewire 1 can be made immobile. With thisconfiguration, the feed-out block 51 therefore functions not only as afeed-out member, but also as a guidewire fixing member.

Second Mode of Embodiment

A guidewire insertion aid 71 according to the second mode of embodimentof the invention will be described in detail below with reference toFIGS. 5 and 6.

As shown in FIG. 5, the guidewire insertion aid 71 according to thismode of embodiment comprises a feed-out block 51 having thewater-retention member 52 on the lower surface thereof. However, thefeed-out member support parts 42 which constitute the structure forsupporting the feed-out block 51 are not present. As the supportstructure used instead of these, the guidewire insertion aid 71comprises a linking member 72 for linking the feed-out block 51 to themain body 21 side. The linking member 72 according to this mode ofembodiment is a flexible strip-like member having a U-shaped curved part73 midway along. In this instance, the linking member 72 is provided asa single piece with the upper surface of the housing support part 22 ofthe main body 21. Accordingly, the main body 21 and the linking member72 are made of a common synthetic resin material (polypropylene) in thismode of embodiment. It should be noted that the linking member 72 mayequally be provided as a single piece with the feed-out block 51.

When this guidewire insertion aid 71 is used, the guidewire 1 is heldbetween the water-retention member 52 on the feed-out block 51 side andthe water-retention member 57 on the sliding contact part 28 side. Inthis state, the feed-out block 51 is then moved forwards or backwardsusing the thumb F1. As a result, the guidewire 1 can be fed out at thetip end side of the main body by way of the feed-out block 51. Eventhough the flexible linking member 72 links the main body 21 and thefeed-out block 51, the curved part 73 is mainly able to extend andcontract through deformation when the feed-out block 51 moves forwardsor backwards (see FIG. 6). This therefore has the advantage that thereis no obstruction to the back-and-forth movement. Furthermore, thisstructure offers the advantage that there are fewer components and thestructure can be simplified, compared with when the feed-out member is aseparate component.

Third Mode of Embodiment

A guidewire insertion aid 81 according to the third mode of embodimentof the invention will be described in detail below with reference toFIG. 7.

As shown in FIG. 7, with the guidewire insertion aid 81 according tothis mode of embodiment, the pair of feed-out member support parts 42are provided. However, the structure of the feed-out member supportedthereby is very different. That is to say, an endless feed-out belt 82is used as the feed-out member. This feed-out belt 82 comprises thewater-retention member 52 over the whole outer peripheral surfacethereof. The water-retention member 52 positioned at the lower surfaceof the feed-out belt 82 faces the water-retention member on the slidingcontact part 28 side. Winding protrusions 84 are provided at four pointson the inside surface of the pair of feed-out member support parts 42.The feed-out belt 82 runs around these winding protrusions 84. As aresult, the feed-out belt 82 is supported between the pair of feed-outmember support parts 42 in a state in which it can movecircumferentially.

When this guidewire insertion aid 81 is used, the guidewire 1 is heldbetween the water-retention member of the feed-out belt 82 and thewater-retention member 57 on the sliding contact part 28 side. In thisstate, the feed-out belt 82 is moved circumferentially using the thumbF1. As a result, the guidewire 1 can be fed out at the tip end side ofthe main body by way of the feed-out belt 82. It should be noted thatthe part which is operated by the thumb F1 may be on the innerperipheral surface or the outer peripheral surface of the feed-out belt82. Moreover, the configuration in this mode of embodiment makes itpossible to increase the size of the water-retention member 52 on thefeed-out belt 82 side. This therefore offers the advantage that theguidewire 1 can be efficiently and reliably lubricated.

Moreover, the modes of embodiment of the present invention may bemodified in the following way.

-   -   In the first and second modes of embodiment described above, a        plurality of anti-slip protrusions 53 were provided on the upper        surface of the feed-out block 51, but it is equally possible to        employ an anti-slip structure in the form of lugs, holes or        grooves etc. Furthermore, this kind of anti-slip structure may        also be provided on the inner peripheral surface of the feed-out        belt 82 in the third mode of embodiment, for example.    -   In the first mode of embodiment described above, the coil spring        56 was provided as the urging member, but any type of spring may        equally be used, such as a compression spring or a tension        spring. Furthermore, the use of springs in forms other than the        form of the coil spring 56 (e.g. leaf springs etc.) is also        permitted as other urging members.    -   In the second mode of embodiment described above, the linking        member 72 was provided as a single piece on the upper surface of        the housing support part 22 of the main body 21, but it may        equally be provided at another position on the main body 21.        Furthermore, the linking member 72 does not necessarily need to        be provided as a single piece with the main body 21, and it may        be provided as a piece produced separately. Furthermore, the        shape of the linking member 72 is not limited to what was        described in relation to the second mode of embodiment above,        and it may be modified in any way.    -   In the third mode of embodiment described above, the feed-out        belt 82 was used as the feed-out member. A different type of        rolling member to the feed-out belt 82 (e.g. a feed-out roller,        etc.) may be used instead, and this rolling member may be made        to roll while the guidewire 1 is pinched between said rolling        member and the eliding contact surface 59.    -   In the first to third modes of embodiment described above, the        rubber ring 35 was used as the guidewire fixing member, but this        does not necessarily imply a limitation. For example, a        ring-shaped member made of a material other than rubber, or a        rubber member having a shape other than a ring shape may also be        used. That is to say, the material and shape of this member are        unimportant, provided that it is a member which can secure or        release the guidewire 1 by contact with or separation from the        guidewire.    -   In the first to third modes of embodiment described above, two        water-retention members were provided, namely the        water-retention member 52 on the feed-out member side and the        water-retention member 57 on the sliding contact part 58 side,        but the water-retention member 57 on the sliding contact part 58        side may be omitted.    -   In the first to third modes of embodiment described above, the        arm part 31 extending in an arcuate shape and the holding part        32 were provided, but they may be omitted.

Moreover, the following technical concepts which can be understood fromthe modes of embodiment of the present invention may be mentioned.

(1) The fact that in the abovementioned means 3, the feed-out block alsofunctions as a guidewire fixing member for fixing the guidewire.

(2) The fact that in any one of the abovementioned means 1 to 6, the armpart extending downwards in an arcuate shape is provided projecting fromthe lower surface of the main body, and the holding part for holding thehousing is provided at the tip end of the arm part.(3) The fact that in any one of the abovementioned means 1 to 6, theprojection is provided on the main body close to the base end opening ofthe guidewire support part, and the rubber ring for securing orreleasing the guidewire is attached correspondingly to the position ofthe projection.

KEY TO SYMBOLS

-   1 . . . guidewire-   2 . . . housing-   11, 11A, 71, 81 . . . guidewire insertion aid-   21 . . . main body-   22 . . . housing support part-   26 . . . guidewire support part-   28 . . . sliding contact part-   29 . . . sliding contact surface-   42 . . . feed-out member support part-   43 . . . guide part-   51 . . . feed-out block serving as feed-out member-   52, 57 . . . water-retention member-   56 . . . coil spring serving as urging means-   72 . . . linking member-   82 . . . feed-out belt serving as feed-out member

The invention claimed is:
 1. A guidewire insertion aid, comprising: aguidewire; a housing supporting the guidewire; an insertion devicesecured to the housing and including: a body having a sliding contactsurface disposed between a proximal end of the body and a distal end ofthe body; and a feed-out member movably supported on the body, thefeed-out member having a water retention member disposed facing thesliding contact surface of the body and being selectively movable toadvance the guidewire between the water retention member of the feed-outmember and the sliding contact surface of the body, the water retentionmember being water retentive to lubricate the guidewire as a result ofcontact between the water retention member and the guidewire, whereinthe body defines a guide that extends longitudinally along the bodyabove the sliding contact surface, the feed-out member being movablysecured to the guide to permit the selective longitudinal advancement ofthe guidewire upon the longitudinal advancement of the feed-out memberlongitudinally along the guide; and an urging member secured to thefeed-out member to urge the feed-out member towards the proximal end ofthe body.
 2. The guidewire insertion aid of claim 1, wherein the housingis detachably secured to the proximal end of the body.
 3. The guidewireinsertion aid of claim 1, further comprising a guidewire support securedto the distal end of the body, wherein the guidewire support issubstantially cylindrically shaped.
 4. The guidewire insertion aid ofclaim 3, wherein the diameter of the guidewire support decreases at adistal end of the guidewire support.
 5. The guidewire insertion aid ofclaim 1, wherein the feed-out member and the body each include alatching protrusion extending therefrom, the urging member beingsecurable to each latching protrusion to provide a spring force to thefeed-out member to urge the feed-out member toward the proximal end ofthe body.
 6. The guidewire insertion aid of claim 5, wherein the guideincludes a curved part at a distal end of the guide, the curved partmaintaining the feed-out member in a distal position when the latchingprotrusion secured to the feed-out member is positioned in the curvedpart.
 7. The guidewire insertion aid of claim 6, wherein the curved partextends downwardly such that when the latching protrusion secured to thefeed-out is positioned in the curved part, the feed-out member engagesthe guidewire to maintain the guidewire in a fixed position.
 8. Theguidewire insertion aid of claim 1, further comprising a flexiblelinking member secured between the feed-out member and the body.
 9. Theguidewire insertion aid of claim 8, wherein the linking member includesa curved portion that deforms as the linking member moves betweenextended and contracted positions.
 10. The guidewire insertion aid ofclaim 1, wherein the feed-out member is an endless feed-out belt havingthe water retention member on an outer peripheral surface of thefeed-out belt, the feed-out belt being supported on the body so that thefeed-out belt moves circumferentially.
 11. The guidewire insertion aidof claim 10, wherein the feed-out belt is secured to a pair of supportshaving winding protrusions extending therefrom, the feed-out belt movingaround the winding protrusions to move the feed-out beltcircumferentially.
 12. The guidewire insertion aid of claim 1, whereinthe sliding contact surface includes a second water retention member.13. The guidewire insertion aid of claim 1, wherein the body includes arib extending longitudinally along a bottom surface of the body toincrease the rigidity of the body.
 14. The guidewire insertion aid ofclaim 1, wherein the body includes a projection at the distal end of thebody adjacent a guidewire support, the projection having a ring securedto the projection, the ring being positionable between first and secondorientations, in the first orientation, the ring inhibits advancement ofthe guidewire through the guidewire support, in the second orientation,the ring permits advancement of the guidewire through the guidewiresupport.
 15. The guidewire insertion aid of claim 1, wherein thefeed-out member includes a plurality of anti-slip protrusions.